MD Whistleblower

Millions of Americans are working remotely during the pandemic.  Many of them would have never believed that they could perform their jobs away from the office.  I’m one of them.  But we all now acknowledge that the basic structure and function of the workplace has been forever altered. This transformation was inevitable, but the pandemic was a potent catalyst to bring it about at, shall I say, ‘warp speed’? Did we really believe that in a world with remote robotic surgery, driverless cars, personalized genetic medicine, exploration of Mars, Alexa and the explosion of artificial intelligence, that we would continue to commute to brick-and-mortar offices each day?   It was only a matter of time before the physical workplace would be recalibrated.   The disruption has been monumental and to a great extent irrevocable.   While I do believe that there will be some backward adjustment after the pandemic has largely resolved, I do not expect a return ...

I am writing this now, prior to the pandemic, from my new favorite coffee shop not far from where I live and work. It’s called Couchland and is located in Wickliffe, Ohio.   As the name suggests, every seat is comfortable.   The large space has several couches and plush armchairs that beckon customers to sink in and stay a while.   This is quite different from many of the other coffee shops I patronize, where upon entering, I scan the room like a seasoned detective to see if any of the few comfortable chairs that are present are still available. Otherwise, I must enjoy the discomfort of a hard wooden chair, a larger version of what I sat on in 3 rd grade.  It’s a cat and mouse game as customers compete for premium seating in an adult version of musical chairs.   And, there are rules of etiquette that at times require adjudication.   For example, is it permissible to plop your backpack on a favorable available seat before standing in line to order? ...

I read recently that Kroger, who runs a grocery store chain, has joined with other retailers in paying employees who receive a COVID-19 vaccination.  The $100 payment should serve as an incentive for employees to roll up their sleeves. There is an ongoing debate whether employers can or should mandate COVID-19 vaccinations for their employees.   The state of play now is that employers are encouraging, but not requiring vaccines, as mandating vaccines creates legal exposure for employers.   For example, if you require that an employee is vaccinated against the worker’s wishes, and a complication occurs, is the employer responsible?   Can an employee be disciplined or terminated for failure to vaccinate if there are no vaccines available within a reasonable distance?   And mandating vaccinations may be complicated when workers are unionized. The right to refuse treatment is a bedrock medical ethical principle that I support.   For example, if I advise an ...

 There are many concepts and activities that we understand, but yet we have difficulty defining.  In 1964, Supreme Court Associate Justice Potter Stewart in an attempt to define pornography and obscenity stated that ‘…I know it when I see it.’    Indeed, this phrase has been embedded in pop culture and is used in circumstances far removed from it’s initial prurient reference. How would one define bipartisanship?   If a bill passes with the votes of 100% of one political party and captures only 1 or 2 votes of the opposition, can the outcome fairly be regarded as bipartisan?   How much support from the other side must exist before the ‘B-word’ can be invoked?   While I don’t have a precise threshold in my mind on this issue,   I don’t think that just a couple of votes is sufficient. Joe Biden was elected in part because of his promise to pursue unity and bipartisanship.   How many times have we all heard about his decades of reaching acr...

 This past week, I received my 2 nd Moderna vaccine uneventfully.  Leaving science aside for a moment, I marveled that a small amount of clear liquid thrust into my upper arm could shield me from a contagious and invisible invader.  Indeed, with the many public health failures we have suffered this past year, the development of safe and effective vaccines in record time has been a monumental scientific triumph.  Obviously, these successes were the result of decades of medical research and development that created a ladder that today’s scientists could ascend.  This is how medical science works.  While it is true that medical breakthroughs can occur ex nihilo – out of nothing – more typically new scientific achievement builds on prior successes and failures.  We've added a few more rungs this past year. Even with the advent of vaccines, this remains an uneasy time.   Yes, there will be additional vaccines added to the armamentarium.   John...

We are all familiar with the ‘butterfly effect’, describing a phenomenon when a seemingly trivial action – a whisper, a smile, a compliment or the fluttering of a butterfly’s wing – causes a soft ripple that can reach a distant continent.   You simply cannot calculate the power and reach of a simple act of kindness. Here’s how it works.   You are in line waiting to buy your first coffee of the day and you discover that the stranger ahead of you has paid for your order.   You are moved by this this simple act of generosity.   Your mood elevates.   You wonder why such an idea never occurred to you.   You ruminate over this on your drive to work.   You greet your secretary who has been under stress and very distracted over her spouse who is recovering at home after surgery.   You think about what that must be like for her and her family.   It’s Thursday morning and you send her home for the rest of the work week so she can help her spouse get ...

I have at times detoured from my typical medical commentaries to rail about the airline industry.   If I may borrow some phrasing from a legendary British Prime Minister, the flying experience is a hassle wrapped in a frustration inside a delay.   We arrive at the airport 2 hours early, drag ourselves through the TSA process, ambulate to the gate, pray the flight is on time, hope that they will not deem my luggage as unfit to carry on, march like snails onto the aircraft, test my lumbar disc strength as I hoist my bag into the overhead bin and then finally relax as I sink into a commodious and plush chair that could comfortably seat a gerbil.   Do I have to sit in the middle seat? And, if the flight is delayed, the inconvenienced passengers can expect no compensation. If my medical practice had adopted airline culture, we would have had no patients. Think of all the reading I could have accomplished!   If we made every office visit with us an unpl...